Malouff Timothy D, Vallow Laura A, Seneviratne Danushka, Mahajan Anita, Foote Robert L, Hoppe Bradford, Beltran Chris, Buskirk Steven J, Krishnan Sunil, Trifiletti Daniel M
Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA.
Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
Int J Part Ther. 2020 Nov 5;7(2):31-41. doi: 10.14338/IJPT-19-00079.1. eCollection 2020 Fall.
Carbon ion radiotherapy (CIRT) is an emerging radiotherapy modality with potential advantages over conventional photon-based therapy, including exhibiting a Bragg peak and greater relative biological effectiveness, leading to a higher degree of cell kill. Currently, 13 centers are treating with CIRT, although there are no centers in the United States. We aimed to estimate the number of patients eligible for a CIRT center in the United States.
Using the National Cancer Database, we analyzed the incidence of cancers frequently treated with CIRT internationally (glioblastoma, hepatocellular carcinoma, cholangiocarcinoma, locally advanced pancreatic cancer, non-small cell lung cancer, localized prostate cancer, soft tissue sarcomas, and specific head and neck cancers) diagnosed in the United States in 2015. The percentage and number of patients likely benefiting from CIRT was estimated with inclusion criteria from clinical trials and retrospective studies, and that ratio was applied to 2019 cancer statistics. An adaption correction rate was applied to estimate the potential number of patients treated with CIRT. Given the high dependency on prostate and lung cancers and the uncertain adoption of CIRT in those diseases, the data were then reanalyzed excluding those diagnoses.
Of the 1 127 455 new cases of cancer diagnosed in the United States in 2015, there were 213 073 patients (18.9%) eligible for treatment with CIRT based on inclusion criteria. When applying this rate and the adaption correction rate to the 2019 incidence data, an estimated 89 946 patients (42.2% of those fitting inclusion criteria) are eligible for CIRT. Excluding prostate and lung cancers, there were an estimated 8922 patients (10% of those eligible for CIRT) eligible for CIRT. The number of patients eligible for CIRT is estimated to increase by 25% to 27.7% by 2025.
Our analysis suggests a need for CIRT in the United States in 2019, with the number of patients possibly eligible to receive CIRT expected to increase during the coming 5 to 10 years.
碳离子放射治疗（CIRT）是一种新兴的放射治疗方式，与传统的光子放疗相比具有潜在优势，包括呈现布拉格峰和更高的相对生物效应，从而导致更高程度的细胞杀伤。目前，有13个中心正在开展碳离子放射治疗，不过美国尚无此类中心。我们旨在估算美国符合碳离子放射治疗中心治疗条件的患者数量。
利用国家癌症数据库，我们分析了2015年在美国诊断出的国际上碳离子放射治疗常见治疗癌症（胶质母细胞瘤、肝细胞癌、胆管癌、局部晚期胰腺癌、非小细胞肺癌、局限性前列腺癌、软组织肉瘤以及特定头颈癌）的发病率。根据临床试验和回顾性研究的纳入标准估算可能从碳离子放射治疗中受益的患者百分比和数量，并将该比例应用于2019年癌症统计数据。应用适应性校正率来估算接受碳离子放射治疗的潜在患者数量。鉴于对前列腺癌和肺癌的高度依赖性以及碳离子放射治疗在这些疾病中的应用不确定性，随后对数据进行重新分析时排除了这些诊断。
在2015年美国诊断出的1127455例新发癌症病例中，根据纳入标准有213073例患者（18.9%）符合碳离子放射治疗条件。将此比例和适应性校正率应用于2019年发病率数据时，估计有89946例患者（占符合纳入标准患者的42.2%）符合碳离子放射治疗条件。排除前列腺癌和肺癌后，估计有8922例患者（占符合碳离子放射治疗条件患者的10%）符合碳离子放射治疗条件。预计到2025年，符合碳离子放射治疗条件的患者数量将增加25%至27.7%。
我们的分析表明2019年美国有必要开展碳离子放射治疗，预计在未来5至10年内可能符合碳离子放射治疗条件的患者数量将会增加。
